- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $19.95 / $46.77 / $181.97
| Facility | | $19.95 | $46.77 | $181.97 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $12.02 / $12.88 / $19.95
| Professional | | $12.02 | $12.88 | $19.95 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $36.31 / $45.71 / $46.77
| Facility | | $36.31 | $45.71 | $46.77 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $7.08 / $7.08 / $53.70
| Professional | | $7.08 | $7.08 | $53.70 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $12.59 / $12.59 / $12.59
| Facility | | $12.59 | $12.59 | $12.59 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $16.98 / $16.98 / $16.98
| Professional | | $16.98 | $16.98 | $16.98 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $45.71 / $53.70 / $85.11
| Facility | | $45.71 | $53.70 | $85.11 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $19.50 / $25.12 / $52.48
| Professional | | $19.50 | $25.12 | $52.48 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $12.88 / $28.84 / $46.77
| Facility | | $12.88 | $28.84 | $46.77 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $12.88 / $15.14 / $79.43
| Facility | | $12.88 | $15.14 | $79.43 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $4.79 / $10.00 / $26.30
| Professional | | $4.79 | $10.00 | $26.30 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $7.94 / $32.36 / $85.11
| Professional | | $7.94 | $32.36 | $85.11 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $16.60 / $20.42 / $25.70
| Facility | | $16.60 | $20.42 | $25.70 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $11.22 / $17.38 / $47.86
| Professional | | $11.22 | $17.38 | $47.86 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $22.39 / $42.66 / $154.88
| Professional | | $22.39 | $42.66 | $154.88 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $33.88 / $33.88 / $79.43
| Facility | | $33.88 | $33.88 | $79.43 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $9.55 / $9.55 / $14.13
| Professional | | $9.55 | $9.55 | $14.13 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $35.48 / $35.48 / $39.81
| Professional | | $35.48 | $35.48 | $39.81 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $29.51 / $46.77 / $93.33
| Professional | | $29.51 | $46.77 | $93.33 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $8.51 / $13.49 / $20.42
| Facility | | $8.51 | $13.49 | $20.42 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $4.90 / $10.00 / $27.54
| Professional | | $4.90 | $10.00 | $27.54 |